I have struggled for years with this but I know now that it is time to move my loved one to a long term facility. Can anyone give me any advice on this move? How do I choose a home? What cost am I looking at? I am currently in San Diego, can anyone recommend any places in the area, I am clueless on where to begin so any advice at all will be very helpful. Thank you.

Hi Scarlett,
I live in San Diego and six months ago I moved my father to a senior care facility. Depending on the condition of your loved one and the condition of the finances available, there are a wide variety of places around the city. My 88-year-old father has vascular dementia. His memory is poor and he has lots of trouble with time and space-related information. He wakes up in the middle of the night thinking it is daytime and may go walking up and down halls, wondering why others aren't awake and why he can't have breakfast yet. But he communicates well and gets along well with people.
I tell you this because the place he now lives treats people in his condition far better than many other 'memory centers'. It has 'Circle of Friends' groups at three different levels of dementia, so the high functioning ones (where he currently is) has about twelve people who are at similar levels. He can wander around the building, go to meals and activities unassisted and there are support personnel and nurses (CNAs mostly) who will redirect him, keep him from leaving the building, give him medications, and go to his room at appointed times if he isn't where they may expect him to be.
This place does come at a higher cost than a number of others I researched. Most of them don't have the 'Circle of Friends' constructs. Most have locked memory centers, although many are large enough and attractive enough that residents may not realize they are locked in. Most have an array of activities directed towards the residents, but they are less directed at focusing resident abilities than keeping them involved. I don't see anything wrong with this, but if there is a chance that my dad will maintain a higher mental level by having activities directed at his general ability, that is what I prefer. They do math problems, discuss historical and current events, fill out Q&A forms, and use their hands to create paper items.
Some places have better food than others. Some places include assisted living and nursing care options so that if your loved one has greater needs in the future, he/she won't have to move to a completely different location.
There are agencies in the city that will help you find the right place. They will find your financial limits and interests, the condition of your loved one, and send you to specific places with whom they have agreements so that if your loved one ends up there, they get a percentage from that location. Note that only some places (usually the higher priced ones) are on their lists. But you are under no obligation to them or the locations they send you.
I hope this helps. I can give you more specific info about some places if you'd like.

Scarlett, that is a decision that we all struggle with. But when you know, you know Once the decision is made to find a facility, then it really gets difficult. Choosing a facility can be a daunting task at first. Just take it a piece at a time and you will find a good fit for Mom.

Randy gave you some good information. So much depends on the level of care your Mom will need and her ability to pay for that care. "Circle of Friends" is a fantastic program. But there are other options as well. My Mom and Dad were both in a locked unit. Dad did exceptionally well there. He had no idea the door was locked. There was a lovely garden to enjoy the outside and plenty of room inside to roam. Activities kept him busy and he didn't like to be too far away from the dining room Mom had a little more difficulty.... but adjusted. If your Mom is ambulatory, with no other health problems, she will probably do well in one of these two types of facilities. If she has other health problems or is the very late stages of dementia, then she may need a nursing home. Her doctor should be able to help you determine the level of care Mom will need.

If there is an agency which will help you investigate the possibilities then use them. If not then ask friends for recommendations. Ask her doctor or a social worker. I started by calling facilities and asking for information to be mailed.... I also ask about waiting list. There are facility you can get into almost immediately... and other that might have waiting list as much as a year or more long. From that information I narrowed down my choices a bit. Then I started visiting facilities. As every question you can think of. Patient schedules, activities available, specialized diets, how they handle disruptive behavior, longevity of staffing, medication policy... and on and on. You will know the right and the wrong ones. This will further narrow down the list. Go to your state web site and check the facility for ratings and penalties. Then go back to the few facilities that are left at different times of the day. Even eating a meal if possible. Visit in the late afternoon and see if residents are sitting or active. My final attack was to ask family member, in the parking lot when staff was not watching, their thoughts about the facility. It's a lot of work and time... but it gives you a good insight into what the facility is all about.

It sounds arduous but once you get started it will make sense and go quicker than you expect Good luck on your search and let us know how it goes..

My mom had fallen and fractured her sacrum shortly after my dad had passed away. We knew that mom was having memory problems, but did not realize the extent that dad was covering for her! To make a long story short, mom was placed in a long term care facility that was recommended to us by an elder care consultant. His advice was to go for a scheduled visit to the facility, which we did. We were quite impressed and placed mom there. A short time later, we realized that things were not as they appeared. My best advice is to check out the facility, not only on a scheduled visit, but stop in at different times of the day. The facility that my mom had been at, had wonderful care during the day, but it was sub-par at night when the administration had gone home for the day. After a little over a year, we moved mom in with us, until we can no longer take care of her. I understand that after mom had left the facility, the nursing supervisor began making unannounced visits and that many of the night time staff have been dismissed.

It was an eye opening experience for us! We know that there are many caring, compassionate facilities out there. Be sure to be an advocate for your loved one. Don't hesitate to let the administration know when you see things going on that you're really happy with and conversely, when you are not.